The activity of hemostatic and oxidative-reduction systems according to different classes of ulcer bleeding
Haemostatic therapy of ulcer bleeding (UB) is based on activation of the coagulation system and depression of the fibrinolytic one. Though not so much attention is paid to the oxidation-reduction system. Aim of the study — To elaborate the recommendations on optimization of hemostatic therapy. Were examined 25 patients with UB. 4 patients were evaluated by Forrest classification, type ІВ, 5 – type ІІА, 6 — type ІІВ, and 10 — type ІІІС. Patients with type ІВ had endoscopic haemostasis procedures. All patients got a standard haemostatic complex. Two patients who were evaluated by Forrest classification type ІІА had bleeding recurrence. The following data was determined in blood plasma: fibrinolytic and proteolytic activity, fibrinase, antithrombin ІІІ, prothrombin index, isolated double bonds, diene conjugates, cetodienes and conjugated trienes, oxidation of neutral and alkaline proteins, malonic aldehyde, renew glutathione, catalase. Patients who were evaluated by Forrest classification type ІІА had both a disorder of redox system and hemostasis system balance, caused by a violation of synthesis of its factors. This contributes to the occurrence of bleeding recurrence. The results of redox system together with the criteria for hemostasis condition can be used to predict the recurrence of ulcer bleeding. Medicinal measures need to be adjusted, and antioxidants together with hepatoprotectors to be prescribed. So, patients with UB recurrence have an excessive activation of lipoperoxidation, low level of basic proteins, decrease in functional capacity of antioxidant mechanisms and hemostasis system imbalance, caused by a violation of synthesis of its factors, it is essential to take into account while predicting UB recurrence, and in case of UB one should add to the medication management those means that inhibit the activity of lipid oxidation and contribute to the restoration of synthesis processes of hemostasis factors. The prospect of further development is the assessment of the effectiveness of an optimized treatment complex.
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